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NPI Code Detail

MEDICARE: SANTIAGO DELBOY MBA, MSW, LCSW

MEDICARE: SANTIAGO DELBOY MBA, MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker150.015496IL
21041C0700XClinical Social Worker149.019286IL

General Provider Information

NPI Number : 1740672682
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANTIAGO DELBOY MBA, MSW, LCSW
Provider Business Mailing Address
First Line : 53 W JACKSON BLVD STE 1632
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3734
Country : US
Telephone Number : 312-520-6096
Fax Number :
Provider Business Practice Location Address
First Line : 53 W JACKSON BLVD STE 1632
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3734
Country : US
Telephone Number : 312-520-6096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2015
Last Update Date : 10/07/2022

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